Lyme disease is an infection causd by Borrelia burgdorferi, a spirochete bacteria. Lyme disease was first recognized in the United States in 1975 after a mysterious outbreak of arthritis in Old Lyme, Connecticut.

How the disease is spread

Lyme disease is spread by the bite of Ixodes ticks that are infected with Borrelia organisms. Ixodes ticks are much smaller than common dog and cattle ticks. Research has indicated that ticks transmit Lyme disease to humans primarily during the nymph stage and these ticks are less than 2mm in size and may not be noticed by a person. They need to be attached to the body approximately 2 days or more for feeding to transmit the bacteria. The bacteria is not present in all ticks, only those that have acquired the infection from feeding on the white-footed mouse, the white-tailed deer and other mammals and birds.

The species of ticks that are known to transmit Lyme Disease have only rarely been identified in Kentucky at this time, and in only certain parts of the state.

The symptoms of Lyme Disease

Lyme disease most often presents with a characteristic "bull’s-eye" rash, an erythema migrans, accompanied by nonspecific symptoms such as fever, malaise, fatigue, headache, muscle aches, and joint aches. The onset of the erythema migrans is usually in 7 to 14 days, but may be as short as 3 days or as long as 30 days. The red rash (erythema migrans) grows larger over a few days to weeks. Allergic reactions to tick saliva sometimes occur at the site of a tick bite, but they occur within hours to a few days after the tick bite. They usually do not expand like Lyme disease rash and will disappear within a few days. Once the infection spreads in the body it may be manifested in the nervous system, the musculoskeletal system or the heart. Some infected individuals have no recognized illness or non-specific symptoms. Lyme disease is rarely if ever fatal, but some patients develop chronic conditions from their infection. Look for the familiar "bulls eye" rash to develop.

When should a person seek medical attention?

If you develop a rash or other symptoms following a tick bite you should seek medical advice. Tell the medical personnel when you experienced the tick bite and if possible keep the tick for species identification.

Treatment and prevention

Lyme disease is treated with antibiotics under the direction of a physician. Patients treated in the early stages usually recover rapidly and completely. Most patients in the later stages of the disease also respond well to antibiotics. It is very important to provide a complete history to the medical personnel and inform them of tick exposures. The symptoms of Lyme disease are similar to many other diseases making it difficult to diagnose if the erythema migrans is not present. There are blood tests, but the results may be confusing depending on the stage of the disease.

There is a vaccine for people who must work in areas where exposure to ticks is a daily reality.

Personal protection from tick bites

Avoid tick-infested areas. Wear light-colored clothing so that ticks can be spotted more easily. Tuck pant legs into socks or boots and shirt into pants. Tape the area where pants and socks meet so that ticks cannot crawl under clothing. Spray insect repellent containing DEET on clothes and on exposed skin other than the face, or treat clothes (especially pants, socks, and shoes) with permethrin, which kills ticks on contact. Wear a hat and a long-sleeved shirt for added protection. Walk in the center of trails to avoid overhanging grass and brush. After being outdoors inspect body carefully and remove attached ticks with tweezers, grasping the tick as close to the skin surface as possible and pulling straight back with a slow steady force; avoid crushing the tick’s body.

Rocky Mountain Spotted Fever

Rocky Mountain spotted fever (RMSF) is a disease caused by the rickettsial organism, Rickettsia rickettsii. It is primarily transmitted to humans by the bite of an infected American dog tick, Dermacentor variabilis and sometimes by other tick species.

How RMSF is spread

A tick attached to the skin for several hours. RMSF is spread by the bite of an infected tick (the American dog tick, the lone-star tick or the wood tick), or by contamination of the skin with tick blood or feces. The tick must be attached at least 4-6 hours to become infectious to people. Person-to-person and direct animal to human spread of RMSF does not occur.

Who is at risk?

In the eastern United States children are infected more frequently and in the Western United States adult males are the most frequently infected persons. Disease incidence is directly related to exposure to tick-infested habitats.

The symptoms of RMSF

RMSF is characterized by a sudden onset of moderate to high fever, which persists for 2-3 weeks in untreated cases, severe headache, fatigue, deep muscle pain, chills and rash. The rash begins on the legs or arms, often includes the soles of the feet and palms of the hands, and spreads to the trunk of the body. Symptoms usually occur within 3 to 14 days of a bite from an infected tick.

How RMSF is diagnosed and treated

A diagnosis of RMSF is based on clinical symptoms and specific laboratory tests to be ordered by your health care provider to confirm that you have the disease.

Prompt treatment, once the symptoms develop, usually prevents serious complications. Specific antibiotics prescribed by a physician are needed.

How can RMSF be prevented?

Avoid tick-infested areas. Wear light-colored clothing so that ticks can be spotted more easily. Tuck pant legs into socks or boots and shirt into pants. Tape the area where pants and socks meet so that ticks cannot crawl under clothing. Spray insect repellent containing DEET on clothes and on exposed skin other than the face, or treat clothes (especially pants, socks, and shoes) with permethrin, which kills ticks on contact. Wear a hat and a long-sleeved shirt for added protection. Walk in the center of trails to avoid overhanging grass and brush. After being outdoors inspect the body carefully and remove attached ticks. Wear gloves or use a tissue when removing ticks to prevent contamination of the skin. With tweezers, grasp the tick as close to the skin surface as possible and pull straight back with a slow steady force; avoid crushing the tick’s body.